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My signature below authorizes Seacoast Youth Services to submit claim forms for me directly to my insurance company but does not guarantee payment of claims. Signature Date Contact Information Parent/Guardian Information 1 Home Address Email Primary Contact Number Home Work Cell Alternative Contact Number Home Work Cell Occupation Employer Relationship Status single committed married separated divorced widowed Partner/Spouse name Past or present medical psychological or substance abuse...
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01
Identify the section in the form that asks for your legal name if different.
02
If you have a different legal name, provide it in the designated field.
03
Include all the necessary details of your different legal name, such as first name, middle name (if applicable), and last name.
04
Ensure that the spelling and order of your different legal name match the official documents you have as proof.
05
Double-check for accuracy and completeness before submitting the form.

Who needs legal name if different?

01
Individuals who have changed their legal name due to marriage.
02
Individuals who have legally changed their name through a court process.
03
Individuals who use a different legal name for professional purposes.
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Individuals who have different legal names in different countries or jurisdictions.
05
Individuals who want to clarify that their current legal name is different from their birth name.
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Legal name if different refers to the name of an individual or entity that is different from their official or registered name.
Any individual or entity that has a different legal name than what is officially registered may be required to file legal name if different.
To fill out legal name if different, the individual or entity must provide the correct legal name that differs from their official registered name.
The purpose of legal name if different is to ensure that accurate and up-to-date information is recorded for identification and legal purposes.
The information that must be reported on legal name if different includes the correct legal name that differs from the official registered name.
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